环境温度对妊娠前和妊娠期间环境臭氧暴露与不良出生结局关联的修饰作用：中国多城市研究。
Modification effects of ambient temperature on associations of ambient ozone exposure before and during pregnancy with adverse birth outcomes: A multicity study in China.
机构信息
Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, China.
出版信息
Environ Int. 2023 Feb;172:107791. doi: 10.1016/j.envint.2023.107791. Epub 2023 Jan 31.
BACKGROUND
Epidemiological studies suggest that both ambient ozone (O) and temperature were associated with increased risks of adverse birth outcomes. However, very few studies explored their interaction effects, especially for small for gestational age (SGA) and large for gestational age (LGA).
OBJECTIVES
To estimate the modification effects of ambient temperature on associations of ambient O exposure before and during pregnancy with preterm birth (PTB), low birth weight (LBW), SGA and LGA based on multicity birth cohorts.
METHODS
A total of 56,905 singleton pregnant women from three birth cohorts conducted in Tianjin, Beijing and Maoming, China, were included in the study. Maximum daily 8-h average O concentrations of each pregnant woman from the preconception period to delivery for every day were estimated by matching their home addresses with the Tracking Air Pollution in China (TAP) datasets. We first applied the Cox proportional-hazards regression model to evaluate the city-specific effects of O exposure before and during pregnancy on adverse birth outcomes at different temperature levels with adjustment for potential confounders, and then a meta-analysis across three birth cohorts was conducted to calculate the pooled associations.
RESULTS
In pooled analysis, significant modification effects of ambient temperature on associations of ambient O with PTB, LBW and LGA were observed (P < 0.05). For a 10 μg/m increase in ambient O exposure at high temperature level (> 75 percentile), the risk of LBW increased by 28 % (HR: 1.28, 95% CI: 1.13-1.46) during the second trimester and the risk of LGA increased by 116% (HR: 2.16, 95%CI: 1.16-4.00) during the entire pregnancy, while the null or weaker association was observed at corresponding low (≤ 25 percentile) and medium (> 25 and ≤ 75 percentile) temperature levels.
CONCLUSION
This multicity study added new evidence that ambient high temperature may enhance the potential effects of ambient O on adverse birth outcomes.
背景
流行病学研究表明，环境臭氧 (O) 和温度均与不良出生结局的风险增加有关。然而，很少有研究探讨它们的相互作用效应，特别是对于小于胎龄儿 (SGA) 和大于胎龄儿 (LGA)。
目的
基于多城市出生队列，估计环境温度对妊娠前和妊娠期间环境 O 暴露与早产 (PTB)、低出生体重 (LBW)、SGA 和 LGA 之间关联的修饰作用。
方法
本研究共纳入了来自中国天津、北京和茂名的三个出生队列的 56905 名单胎孕妇。通过将每个孕妇的家庭住址与中国空气质量追踪 (TAP) 数据集相匹配，估算了每个孕妇从受孕前到分娩时每天的最大日 8 小时平均 O 浓度。我们首先应用 Cox 比例风险回归模型，在不同温度水平下，评估妊娠前和妊娠期间 O 暴露对不良出生结局的城市特异性影响，并进行了三个出生队列的荟萃分析以计算汇总关联。
结果
在汇总分析中，观察到环境温度对环境 O 与 PTB、LBW 和 LGA 之间关联的显著修饰作用 (P<0.05)。在高温水平 (>75 百分位) 下，O 暴露每增加 10μg/m，中孕期 LBW 的风险增加 28% (HR：1.28，95%CI：1.13-1.46)，整个孕期 LGA 的风险增加 116% (HR：2.16，95%CI：1.16-4.00)，而在相应的低温 (≤25 百分位) 和中温 (>25 和≤75 百分位) 水平下，这种关联则较弱或不存在。
结论
这项多城市研究提供了新的证据，表明环境高温可能增强环境 O 对不良出生结局的潜在影响。
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